Abstract :
Context: Cytological techniques are used as first line diagnostic tool in suspected lung tumors, based on which crucial management decisions are made. Bronchial brush (BB) and bronchial wash (BW) are two commonly employed techniques with variable diagnostic yield. This study compared the efficacy of BB and BW in diagnosing lung tumors.
Aims: To study sensitivity of BW and BB cytology in diagnosing lung tumours by correlating with biopsy as gold standard. To study the efficacy of BW and BB in typing the lung tumors.
Methods and Material: A cross sectional observation study for a period of 5 years was done. A total of 176 cases, suspected of lung cancer between January 2015 and December 2019 were selected, where cytology samples of BB or BW or both along with biopsy were obtained. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated separately for BB and BW.
Statistical analysis used: All data were analyzed using SPSS software version 20.
Results: Sensitivity of BB was significantly higher (77.8%) when compared to BW (51.9%), while specificity was better for BW (90.9%) compared to BB (80%). Positive predictive value of BW was higher (97.6%) compared to BB (93.3%). Negative Predictive value of BB and BW was 50% and 21.3% respectively. BB showed better accuracy (78.3%) compared to BW (56.85).
Conclusions: BB is a much superior technique in diagnosing lung tumors, as it demonstrates far better sensitivity and accuracy. However, since specificity is higher with BW, both techniques should be concurrently used to obtain maximum diagnostic yield. BB has better efficacy in typing squamous cell carcinoma followed by small cell carcinoma and adenocarcinoma while BW is superior in typing small cell carcinoma followed by squamous cell carcinoma and adenocarcinoma
Keyword :
Bronchial brush, Bronchial wash, Lung tumors.